Funding
for
this
study
was
included
as
a
congressional
project
in
the
fiscal
year
2003
appropriation
for
the
Centers
for
Disease
Control
and
Prevention.
The
relevant
portion
of
House
Report
108-10
reads
as
follows:
“The
conferees
include
the
following
amounts
for
the
following
projects
and
activities
in
fiscal
year
2003:
Medical
Institute
for
Sexual
Health;
$250,000.”

Executive
Summary

Adolescents
in
the
United
States
are
engaging
in
sexual
activity
at
early
ages
and
with
multiple
partners.
Approximately
46%
of
high
school
students
have
had
sexual
intercourse
–
6.6%
of
these
before
the
age
of
13,
and
14%
with
four
or
more
sexual
partners.1
Sexually
active
adolescents
are
at
immediate
risk
for
pregnancy
and
acquiring
sexually
transmitted
infections
(STIs)
and
are
also
at
risk
for
depression
and
suicide.
Each
year
nearly
900,000
teenage
girls
in
the
US
become
pregnant
–
340,000
are
17
or
younger
–
and
35%
of
American
teenage
girls
have
been
pregnant
at
least
once
by
age
20.2
In
the
United
States
the
risk
of
acquiring
an
STI
is
higher
among
teenagers
that
among
adults.3

A
critical
review
of
the
scientific
literature
and
other
sources
shows
that
one
largely
unexplored
factor
that
may
contribute
to
adolescent
sexual
activity
is
their
exposure
to
the
mass
media.

The
average
American
youth
spends
one-third
of
each
day
with
various
forms
of
mass
media,
mostly
without
parental
oversight.4

The
mass
media
have
been
shown
to
affect
a
broad
range
of
adolescent
attitudes
and
behaviors,
including
violence,
eating
disorders,
and
tobacco
and
alcohol
use.

Few
studies
have
examined
the
effects
of
mass
media
on
adolescent
sexual
attitudes
and
behavior.

An
extensive,
systematic
review
of
the
relevant
biomedical
and
social
science
literature
shows
that
only
19
of
2,522
research-related
documents
(<1%)
involving
media
and
youth
address
the
effects
of
mass
media
on
adolescent
sexual
attitudes
and
behavior
(Appendix
1).

Television,
Cable
TV,
and
Music
Videos

Exposure:
The
average
teenager
spends
3
to
4
hours
per
day
watching
television.4

Content:
For
every
hour
of
programming
watched
by
adolescents,
an
average
of
6.7
scenes
included
sexual
topics5
and
about
10%
of
scenes
show
portray
couples
engaging
in
sexual
intercourse.6-8
One-third
of
shows
with
sexual
content
involve
teen
characters.5-8

Effects:
Several
studies
suggest
an
association
between
media
exposure
and
adolescent
sexual
behavior,
but
they
are
limited
because
of
their
study
designs,
sampling
procedures,
and
small
sample
sizes.
We
do
not
know
the
relationship
over
time
between
exposure
to
television
and
sexual
initiation
in
adolescents.
The
only
study
in
this
area
is
a
secondary
analysis
of
data
collected
for
other
purposes.
As
such,
it
lacks
a
rigorous
measurement
methodology
to
accurately
examine
the
effects,
if
any.9

Adolescents
exposed
to
TV
with
sexual
content
are
more
likely
than
other
adolescents
to:

·
Overestimate
the
frequency
of
some
sexual
behaviors10

·
Have
more
permissive
attitudes
toward
premarital
sex11

·
Think
that
having
sex
is
beneficial.12

Movies

Exposure:
Two-thirds
of
Hollywood
movies
made
each
year
are
R-rated
and
most
young
people
have
viewed
these
movies
before
they
reach
the
required
age
of
16.13
“In
the
only
study
involving
exposure
and
effects
of
adult
oriented
movies
(note
that
the
study
itself
refers
to
“X-rated”
movies),
30%
of
minority
adolescent
females
said
they
had
seen
an
NC-17
rated
movie
3
months
prior
to
the
survey.14

Content:
Two
studies
have
analyzed
the
content
of
the
top
movie
video
rentals
and
R-rated
movies
frequently
viewed
by
youth.13,15
Both
studies
reported
a
high
amount
of
sexual
content
with
the
most
common
sexual
activity
being
intercourse
between
unmarried
partners.

Effects:
Adolescents
who
are
exposed
to
NC-17
rated
movies
are
more
likely
to:

·
Have
multiple
sexual
partners

·
Have
sex
more
frequently

·
Test
positive
for
chlamydia

·
Have
more
negative
attitudes
toward
using
condoms

·
Not
use
contraceptives14

We
do
not
know
if
the
sexual
content
of
R-rated
movies
has
comparable
effects.

Radio

Exposure:
Adolescents
listen
to
radio
nearly
40
hours
a
week.16

Content:
22%
of
teen-oriented
radio
segments
contain
sexual
content;
20%
of
these
were
“pretty
explicit”
or
“very
explicit.”17

Effects:
We
do
not
know
the
effect
of
exposure
to
radio
on
adolescent
sexual
attitudes
and
behaviors.

Music

Exposure:
Teenagers
spend
an
average
of
over
20
hours
per
week
listening
to
music.4

Content:
42%
of
the
top-selling
CDs
in
1999
contain
sexual
content;
41%
of
these
were
“pretty
explicit”
or
“very
explicit.”
17

Effects:
We
do
not
know
the
impact
of
sexually
explicit
lyrics
on
adolescent
sexual
attitudes
and
behaviors.

Magazines

Exposure:
85%
of
teens
have
read
or
looked
at
a
magazine
in
the
last
6
months.18

Content:
There
are
few
scientific
data
on
the
content
of
the
magazines
adolescents
read.

Effects:
We
do
not
know
the
impact
of
sexually
explicit
magazines
or
of
“mainstream”
publications
on
adolescent
sexual
attitudes
and
behaviors.

Advertising

Exposure:
The
average
American
child
sees
an
estimated
20,000
advertisements
each
year.
By
age
19
the
average
American
adolescent
has
absorbed
nearly
300,000
advertisements.19

Content:
American
teens
currently
spend
about
$153
billion
per
year,
an
average
of
$89
per
week
per
teen.20
Therefore,
they
comprise
a
specific
target
audience
for
much
consumer
advertising.

Nontraditional
advertising
messages
that
feature
embedded
and
subtle
messaging
(such
as
product
placement)
are
more
influential,
appealing,
and
effective
with
teens
than
more
overt
approaches.21
However,
there
is
little
scientific
data
about
the
implicit
and
explicit
content
of
either
overt
or
embedded
advertising.

Effects:
We
do
not
know
the
impact
of
the
sexual
content
of
advertising
on
adolescent
sexual
attitudes
and
behaviors.

Video
and
Computer
Games

Exposure:
70%
of
households
surveyed
in
1999
reported
having
a
video
game
system.4

Content:
There
are
no
systematic
data
concerning
the
sexual
content
of
computer,
video,
and
Internet
games
most
popular
with
adolescents.

Effects:
We
do
not
know
the
impact
of
the
sexual
content
of
video
and
computer
games
on
adolescent
sexual
attitudes
and
behaviors.

The
Internet

Exposure:
On
average,
children
9–17
years
old
use
the
Internet
4
days
per
week
and
spend
almost
2
hours
online
at
a
time.22

61%
of
teens
using
computers
“surf
the
net,”
and
14%
report
“seeing
something
they
wouldn’t
want
their
parents
to
know
about.”23

Content:
While
pornography
is
widely
available
on
the
Internet,
there
are
no
systematic
data
concerning
the
sexual
content
of
those
sites
visited
by
adolescents.

Effects:
We
do
not
know
the
impact
of
sexual
content
on
the
Internet
on
adolescent
sexual
attitudes
and
behaviors.

Gaps
in
knowledge

Several
gaps
have
been
identified:

We
do
not
know
the
extent
of
sexual
content
in
radio,
advertising,
magazines,
the
Internet,
or
chat
rooms.

We
do
not
know
the
extent
of
adolescents’
exposure
to
such
content.
There
is
a
notable
scarcity
of
well-conducted,
scientifically
rigorous
studies
that
examine
the
impact
of
sexual
content
in
the
media
on
adolescent
sexual
attitudes
and
behaviors.

There
are
no
studies
that
have
examined
the
cumulative
effects
of
sexual
content
in
different
types
of
media
over
time
on
developing
youth.

Future
Directions

Based
on
this
review
of
the
scientific
literature,
studies
are
needed
to

Refine
methodologies
to
measure
mass
media
exposure
and
exposure
to
sexual
content
in
the
media.

Survey
adolescents
to
determine
their
exposure
to
forms
of
mass
media
for
which
data
are
lacking
and
also
survey
parents
to
assess
the
effectiveness
of
parental
involvement,
communication,
supervision,
and
monitoring
of
media
sexual
content
on
these
adolescent
exposures.
Findings
from
these
initial
short-term
(cross-sectional)
studies
can
be
used
to
guide
longer
term
(longitudinal)
studies
to
assess
the
impact
of
exposure
on
adolescents’
attitudes,
values,
and
sexual
risk
behaviors.

Evaluate
effects
of
mass
media
on
child
and
adolescent
sexual
attitudes
and
behaviors
over
time
(longitudinal
studies).

21.
A
Day
in
the
Life
of
a
Teen:
A
Diary
Approach
to
Getting
the
Inside
Information
[audiovisual
presentation]
[PowerPoint
presentation;
41
slides].
Office
of
National
Drug
Control
Policy,
Ogilvy.
New
York:
Ogilvy;
2003.

22.
American
Academy
of
Pediatrics,
Committee
on
Public
Education,
American
Academy
of
Child
and
Adolescent
Psychiatry,
American
Psychological
Association.
Sexuality,
contraception,
and
the
media.
Pediatrics
2001
Jan;107(1):191-4.